Liver Transplant

A liver transplant is a surgical procedure that places a healthy liver from a deceased or live donor into a person whose liver is failing and can no longer function properly. When the liver comes from a live donor, part of the donor’s liver is removed and transplanted to replace the failing liver. Because the liver regenerates, the donor’s liver eventually returns to its normal size after a living donor liver transplant.

Liver transplants are usually recommended when the liver has been damaged to the point that it cannot perform its normal functions.

After you have completed the necessary medical tests and received insurance approval for a liver transplant, the transplant selection committee at Scripps will review the results ensure it is safe for you to undergo transplant surgery. At that time, you will be placed on the wait list for a liver donation.

The tests are part of the evaluation process and are required to make sure you meet important liver transplant criteria and it is safe for you to receive a transplant. For example, if you were found to have heart disease during your evaluation, you may need a new medication or procedure before it would be safe for your heart to undergo transplant surgery.

The entire evaluation process may take from one month to several months, depending on your condition and how quickly you can complete the necessary tests.

Several factors determine how long you will need to wait for your liver transplant, including:

• How quickly you complete the evaluation testing
• The results of your evaluation testing
• Whether you have other medical conditions that require a waiting period, such as cancer treatment
• Your blood type (certain blood types typically wait longer than others)
• How your immune system reacts to cells or organs from other individuals
• How long you have been on the wait list

If the liver is coming from a cadaveric (deceased) donor, patients generally may wait months to years for a transplant. For patients with a living donor, the wait can be significantly shorter because they need to wait only as long as it takes to complete both their evaluation and that of their donor (usually a few months).

In most cases, the new liver should last for the rest of your life. However, several factors may affect this timeframe, including:

• Recurrence of the disease that damaged your original liver
• Rejection of the new liver by your immune system
• Infection
• Reaction to a medication you are taking

Fortunately, in most cases these problems can be treated.

When you first go home after your transplant, you will need to take approximately 10 to 12 new medications. These medications lower or “suppress” your immune system, so that it will accept a liver from someone else. Without these medications, your immune system would reject and attack your new liver. Immunosuppression medications have a number of side effects, including raising your risk of certain infections. Some patients cannot take traditional steroid-based drugs for immunosuppression. These patients may qualify for steroid-free immunosuppression.

Over time, your transplant physician will reduce the number of medications you take, but you will need to take some immunosuppression medications for life.

You will be in the hospital for about a week after liver transplant surgery. When you go home, you will need help taking care of yourself. If you are an out-of-town patient, you will need to plan to stay locally following your transplant for as long as your physician recommends. For the first four to six weeks, you must avoid lifting anything heavier than a phone book.

Most patients can get back to a relatively normal life about three months after a liver transplant. It will probably be two to three months before you are ready to drive, and probably three to six months before you are ready to go back to work. Some patients recover quickly, and some need more time. Your recovery also will depend on how ill you were before your transplant and whether you have any complications after the liver transplant surgery. Your transplant team can answer questions about activities during recovery. 

The Scripps transplant team is composed of an established, multidisciplinary panel of surgeons and hepatologists who are nationally recognized as leaders in their field at the forefront of the latest advancements and treatment options. 

This team is complemented by a comprehensive medical staff specially trained to care for transplant patients, and provides the full range of services our patients need to be successful.

In addition to our surgical expertise, our strengths include a broad range of medical and support services, such as our multidisciplinary team of caregivers, including:

• Transplant coordinators
• Financial coordinators
• Social workers
• Transplant dietitians
• Pharmacists

Your transplant care team will be your partner before, during and after the liver transplant surgery and beyond. We’ll work closely with your insurance carrier, referring primary care physician, hepatologist and other specialists involved in your care to ensure all of your health care needs are addressed with efficiency and compassion.

Our approach to medical care ensures that all of our patients receive treatment plans that are customized to their individual needs. For example, patients who cannot take traditional steroid-based drugs to prevent organ rejection following a transplant may qualify for steroid-free immunosuppression.

In order to discover new treatment options and better transplant methods, our physicians participate in a variety of research activities.

View our list of active clinical trials at Scripps Health.